• Frequently Asked OB questions
• Frequently Asked GYN questions

Frequently Asked Obstetrics Questions

1. “Can you give me some suggestions for managing my Nausea and Vomiting during pregnancy, especially during the first trimester?”

YES!
*Keep crackers, Melba toast, or dry cereal within reach of your bed. Eat some before getting up.
*Eat frequent small meals.
*Avoid allowing your stomach to become empty as this can increase nausea.
*Try to take adequate fluids, even small sips, if you can’t handle solids. Try clear juices, flat sugar-sweetened soft drinks, Gatorade, lemonade, ginger ale, tea, like ginger tea and peppermint tea.
*Avoid drinking coffee and caffeinated teas.
*Avoid drinking citrus fruit juices and large amounts of water.
*Drink liquids mainly between meals.
*Try to avoid cooking odors that make you feel ill.
*Avoid or limit your intake of high-fat and spicy foods.
*Sometimes Vitamin B6 may be helpful (50 mg a day).
*Sea bands, which are worn on the wrist and push on an acupressure point, may help.
(These may be found in any drug store.).
*If you have a bad taste in your mouth, hard candy may help.

2. “I just found out I was pregnant. I usually have one Diet Coke a day and like to add some sort of artificial sweetener to my coffee. May I continue to do so?”

Yes, you may continue to do so as there is no scientific evidence to suggest that Equal/ Nutrasweet (Aspartame), Splenda (Sucralose), Sweet’N Low (Saccharin) or Truvia (Stevia- based sugar substitute) are harmful in pregnancy. Nonetheless, it seems prudent to recommend that any of these sugar substitutes, found in most diet drinks and artificially sweetened waters, be used in moderation.

3. “I am pregnant and have allergy/cold/flu symptoms. Which over the counter meds are safe to use?”

Our Careforyouobgyn.com website has a Prenatal tab with a Safe Medications Chart for your reference. If your symptoms persist or a fever develops, please contact your Primary Care (Internal Medicine) physician.

4. “I have a toothache and would like to see my dentist. Is there any guideline that we need to follow?”

Patients may receive dental x-rays for problem visits, if double-shielded and may have injectable anesthetics for procedures. Following any dental procedures, pregnancy category safe antibiotics and certain pain medications may be used. Tylenol, plain or extra-strength, is allowed. NSAID’s (e.g. Aleve, Advil, Motrin, and Aspirin) should NOT be used. Routine cleanings and fillings are fine.

5. “I am pregnant. Is it safe for me to get the Flu Vaccine?”

Flu shots are not only safe, they are strongly recommended for pregnant women by the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Pediatrics (AAP). The flu season is usually November through March, but can last into May. The shot is made from killed viruses and is safe for mother and baby. Pregnant women should NOT receive the nasal-spray flu vaccine, which is made with live attenuated (weakened) virus. You will need a flu shot even if you have had one in previous years because different strains of flu come around every year. The flu vaccine will also protect you against H1N1 (the “swine flu”). You should get the flu shot as soon as it is available regardless of which trimester you are in, when it becomes available.

6. “Can I still have my daily serving(s) of coffee/tea/coke?”

Some people will discontinue their caffeine intake altogether when they’re pregnant, but contrary to what you may read, there is no good scientific evidence to show that caffeine causes problems in human pregnancy. It is a stimulant, however, and it does cross the placenta. Therefore, it seems reasonable to avoid consumption of large quantities of coffee. One or two caffeine-containing beverages a day seems reasonable. If you are accustomed to a much higher daily caffeine intake, then you may need to titrate down while you are trying to conceive, to make this transition easier.

7. “Is it safe to eat deli meats during pregnancy?”

Deli meats, hot dogs and luncheon meats are safe to eat during pregnancy as long as they are reheated until steaming hot. Although rare, any undercooked meat or processed meat may contain a harmful type of bacteria, known as Listeria, which could lead to premature delivery, miscarriage, stillbirth or serious health problems for the newborn. Please also keep in mind that deli meats are often high in sodium and therefore consumption should be limited.

8. “Is it safe to eat fish and seafood during pregnancy?”

Seafood can be a great source of protein and iron during pregnancy. In addition, omega-3 fatty acids in many fish can promote baby’s brain development. Limiting fish and seafood from your diet during pregnancy may contribute to a child having poor verbal skills, behavioral problems and early developmental issues.

It is best to avoid fish that contain high levels of mercury, such as shark, swordfish, king mackerel and tilefish. During pregnancy, a high level of mercury in the bloodstream can damage the baby’s developing brain and nervous system.

Most fish and seafood contain little mercury and are safe to eat. The Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) say pregnant women can safely eat up to 12 ounces a week or two average meals of shrimp, canned light tuna (limit albacore tuna and tuna steak to no more than 6 ounces a week), salmon, pollock, and catfish.

9. “What cheeses should I avoid during pregnancy?”

Avoid unpasteurized (raw) milk and foods as they may contain a harmful type of bacteria, known as Listeria, which could lead to premature delivery, miscarriage, stillbirth or serious health problems for the newborn. Soft cheeses such as feta, brie and queso fresco are commonly unpasteurized in countries other than the United States. All cheeses sold in stores in the United States are pasteurized, therefore safe to eat, but do NOT eat them if sold in a market or foreign grocery store that cannot confirm pasteurization.

10. “I am newly pregnant and I have an appointment to have my hair dyed / highlighted / permed this week. Is it safe to do so while I’m pregnant?”

Unfortunately, there is no way we can give our stamp of approval on this. There is no clinical evidence proving its safety or harm during pregnancy. If you do choose to have your hair colored or permed, we recommend that you wait to do so at least until the first trimester is completed and the baby’s vital organs have developed, then do so sparingly.

11. “My family is planning on going overseas by plane when I’ll be 28 weeks gestation. May I go with them? What do I need to avoid?”

physician. You will have our clearance to FLY as long as you complete your travel by 35 weeks gestation. We would encourage you to complete your air travel closer to 32 weeks gestation, if you will be travelling to more remote locations or if your air travel will last longer than 3 hours, as you will be much more uncomfortable sitting for any prolonged period of time as you progress further in your 3rd trimester. We strongly advise you to hydrate well before and during your flight, and in flight, to ambulate every 1-2 hrs. Depending on the location of your arrival, choose food and drink wisely, if necessary drink only bottled water. Also be sure to order your meat / fish fully cooked and only partake of pasteurized dairy products. These steps will help minimize your risk of foodborne illnesses.

**Please be advised that most CRUISE LINES require their pregnant passengers to complete travel by or before 24 weeks gestation. **

12. “If I have been in/directly exposed to Fifth’s Disease (Parvovirus), do I need to be tested?”

This is a common question amongst our patients who teach at the elementary school level. We often advise you to have the Parvovirus titer (IgG/IgM) blood test drawn to see if you have any antibodies or active infection. Quite often we find that many of our patients have previously been exposed and have developed antibodies to protect them against future infection. Fifth’s Disease is most commonly seen in school age children, and presents with fever and a rash on the face that may spread to the trunk and extremities. For adults, symptoms usually present as fever with joint swelling and pain.

13. “Before I conceived, my exercise regimen consisted of running, strength training and yoga. Can I continue that regimen now that I am pregnant?”

It is fine to continue with the exercise routine to which your body is accustomed. It is important to keep your body temperature cool; this is accomplished by hydrating well before, during and after your workout. You should keep your heart rate at a moderate level, or at the level where it was during your exercise routine prior to pregnancy. If you are able to maintain a light conversation while exercising, then you will know that you are not “over-doing it.” You will need to avoid strenuous exercise as pregnancy is NOT the time to “push through” your work-out. Avoid doing any abdominal crunches. If you feel sore or crampy, then you should modify your routine by decreasing the duration and intensity of your exercise program. LISTEN TO YOUR BODY.

14. “What do you recommend that I use to help treat my constipation and gas pain, caused by my iron supplement?”

Over the counter Miralax or Colace (as directed) will help soften stool. We also advise a daily intake of 64-80 oz. of water, a warm non-caffeinated beverage in the morning, a small glass of prune juice or a couple of prunes, a 15 minute walk 1-2 times/day, and high-fiber foods. You should also AVOID white breads and starches.

15. “I’ve heard that I shouldn’t sleep on my back. Is that true?”

It is best that you stop sleeping on your back by 20 weeks gestation. At this point, the uterus is large enough to put pressure on your inferior vena cava, thereby reducing blood flow to your placenta. You may have also heard that it is best to sleep on your left side. As long as you avoid sleeping flat on your back, and tilt yourself at least 30 degrees to the left or right, you will not be inhibiting blood flow to the placenta.

16. “I am experiencing an increase in indigestion as the baby grows. What can I do?”

The baby is beginning to impinge on your bladder, lungs and stomach, making it more uncomfortable for you as he grows. For indigestion, you’ll want to partake of smaller, more frequent meals, avoid spicy foods, eat slowly, avoid eating 2 hours before bedtime and sleep slightly elevated. You can use over the counter medications such as: Tums, Maalox, Mylanta, Rolaids, Zantac or Prilosec. You should NOT take Pepto-Bismol.

17. “I’m up all night with cramps in my legs, but nothing in my activity has changed. What might be causing this to occur?”

Three possible factors are hydration, calcium, and potassium intake. We recommend that you drink 64-80 oz. of water daily. We know this is a lot! If you fall below this amount of water, it may allow for muscle cramping to occur. During pregnancy, the recommended daily intake of calcium is 1500 mg. Your prenatal vitamin includes only about 150-200 mg of Calcium; the rest should come from your dietary intake: Milk, yogurt, cheese, dark green leafy vegetables, nuts, beans, etc. Increasing potassium rich foods such as tomatoes, oranges and bananas may also be helpful.

18. “During the day, when I am at work or running errands, I barely feel my baby move, but at night, he is very active. Is this ok?”

You are much less likely to notice subtle fetal movements when you are active and otherwise engaged. If you are uncomfortable with the amount of time that has passed with no fetal movement, then you should try to elicit it by trying the following:
-Get off of your feet and elevate them.
-Drink something cold, sweet or caffeinated.
-Have a snack or meal.
-“Focus your attention” to fetal movement.
-Slowly, palpate the sides of your belly.

IF YOU CANNOT ELICIT 4 FETAL MOVEMENTS IN AN HOUR, PLEASE IMMEDIATELY CONTACT OUR OFFICE!

19. “I am in my 3rd Trimester and am terribly uncomfortable all the time. Do you have any suggestions?”

There are plenty of things to try depending on what bothers you. You may need to be creative since you are limited with medication use in pregnancy. Don’t underestimate a long soak in a nice warm tub, followed by a Tylenol or Benadryl before bedtime. Consider a massage at a local spa, or by your husband… (These are skills that he may use again while you are in labor!). For more severe pain, you may find relief through physical therapy or chiropractic care, but these services may not be covered by your insurance or may require referral from your primary care physician first.

20. “What are the symptoms of preterm labor that should cause me to call the office or the on call doctor after hours?”

-Regular cramping or tightening of the abdomen (If < 30 weeks, >4 an hour // If >30 weeks, >6 an hour)
-Constant leakage of watery fluid
-Bleeding

21. “I am now more than 37 weeks pregnant. When should I call the doctor if I think I am in labor or should I just go to the hospital?”

YOU SHOULD ALWAYS CALL THE DOCTOR FIRST, BEFORE PROCEEDING TO THE HOSPITAL.

1. least every 4-5 minutes, which you cannot walk or talk through, and that have been that way for at least one hour.
   IF THIS IS NOT YOUR FIRST BABY, you should call the doctor when your contractions are in a regular pattern and you cannot get comfortable during them.
2. You should call the doctor no matter what time it is, day or night, if you think your water has broken and you have constant leakage of watery fluid.
3. You should call the doctor if you have vaginal bleeding. It is normal to have “Bloody Show” which may look like bright red blood mixed with mucus or old brown blood mixed with mucus, similar to what you might experience on the first day of your period. Spotting may also occur following a prenatal visit where your cervix was checked for dilation. Any vaginal bleeding more than spotting, however, should be evaluated.

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